KERRY LYNN PITCHFORD (NPI# 1205455763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205455763 |
| Entity Type | Individual |
| Full Name | KERRY LYNN PITCHFORD |
| Credential | APRN, FNP-BC |
| Practice Address |
602 S 42nd St Mount Vernon IL 62864-6264 |
| Mailing Address |
Po Box 955860 Saint Louis MO 63195-9537 |
| Practice Telephone | 6188993278 |
| Mailing Telephone | 6364985944 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WE0003X |
Registered Nurse Specialization: Emergency |
041378652 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209021133 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1491 Burge Rd, Centralia, IL 628019537 | 6182679616 |
| Street Address |
602 S 42ND ST |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346233152 | Jason Mulholland | Specialist/Technologist | 602 S 42nd St, Mount Vernon, IL 62864-6264 | 2005-08-26 |
| 1336656537 | Victoria Koch | Nurse Practitioner | 602 S 42nd St, Mount Vernon, IL 62864-6264 | 2018-01-09 |
| 1982123899 | Nicole Marie Lewis | Nurse Practitioner | 602 S 42nd St, Mount Vernon, IL 62864-6264 | 2017-09-12 |
| 1477697977 | Kristi Ann Brown | Physical Therapist | 602 S 42nd St, Mount Vernon, IL 62864-6264 | 2007-02-16 |
| 1376582999 | Sudeep Nair | Internal Medicine | 602 S 42nd St, Suite B, Mount Vernon, IL 62864-6264 | 2006-06-06 |
| 1942250287 | Jason Paul White | Physical Therapist | 602 S 42nd St, Mount Vernon, IL 62864-6264 | 2006-05-10 |
| 1750358578 | Tracy Hamon | Physical Therapist | 602 S 42nd St, Mount Vernon, IL 62864-6264 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421066 | Amantha Theodore | Nurse Practitioner | 531 E Lincoln Ave Apt 4n, Mount Vernon, NY 10552-3743 | 2020-09-15 |
| 1093320392 | Ryan Michael Winder | Nurse Practitioner | 615 A Ave Se, Mount Vernon, IA 52314-1532 | 2020-09-14 |
| 1154969103 | Sarah Jacqueline Lim-dwyer | Nurse Practitioner | 1400 East Kincaid Street, Mount Vernon, WA 98274-4127 | 2019-12-19 |
| 1306481056 | Julie Marie Forbes-laborde | Nurse Practitioner | 27 Beekman Ave Apt 2, Mount Vernon, NY 10553-1491 | 2019-11-15 |
| 1447819305 | Gladys E Aideyan | Nurse Practitioner | 130 Stuyvesant Plz, Mount Vernon, NY 10552-1413 | 2019-06-13 |
| 1417467929 | Shernette T Suer | Nurse Practitioner | 105 Stevens Ave Ste 506, Mount Vernon, NY 10550-2683 | 2017-10-10 |
| 1194254946 | Amy Haibel | Nurse Practitioner | 206 S Mulberry St Ste B, Mount Vernon, OH 43050-3331 | 2017-06-06 |
| 1699216697 | Diana Mcnear | Nurse Practitioner | 421 S 3rd Ave, Mount Vernon, NY 10550-4507 | 2017-03-10 |
| 1598200867 | Vivienne Iona Bartley | Nurse Practitioner | 115 Primrose Avenue, Mount Vernon, NY 10552 | 2016-12-22 |
| 1144772955 | Tahiesha Tolbert | Nurse Practitioner | 153 Stevens Ave Ste 4, Mount Vernon, NY 10550-2543 | 2016-10-27 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on KERRY LYNN PITCHFORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.